San Pablo
2014
City ofSan Pablo
Recreation Division
2450 Road 20
San Pablo. CA 94806
Cii' Ya Sara PABLO
Field RentaIFee Waiver Application
Copies of the following items are required at the time of gppliQatiotlsybHittql 1 )
2)
3)
4)
5)
501(c) Status / IRS documentation - Articles of Incorporation Current Organization Roster of Membership
a) Roster must include player's names, guardians, and addresses List of Organization Officers and Contact Information
Certificate of Insurance
a) Must be valid for the season requested
b) List the "City of San Pablo" as the additionally insured party for the season Copy of Organizations bylaws or articles of incorporation
CITYOFSAN PABLO STAFFUSEONLY
Received By: Date
CounciIReview Date CounciIDecision Date
SpecialConditions
FEE WAIVER REQUEST DETAILS
Season:'9/#4 - 207.3 1 ,
Season Dates: '7 2."5 'LO 6.2 -.}D \'l
*LocationRequested {)].ai< Dac\q ' T 'l
*lf requesting the Davis Park location, your group must schedule a mandatory parent meeting to be had with Community Services and the Police Department to discuss Darkina restrictions to address oublic safety concerns.